Stroke Flashcards

0
Q

Broca’s area location, blood supply, function

A

inferior frontal gyrus, anterior to articulatory areas of primary motor cortex; LEFT BRAIN

blood: superior division MCA
function: word production (motor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Wernicke’s area location, blood supply, function

A

superior temporal gyrus, adjacent to primary auditory cortex, inferior to sylvian fissure. LEFT BRAIN
Blood: inferior division MCA
Function: language processing. damage can lead to fluent aphasia, difficulty understanding language

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

association cortex, location, function, blood supply

A

nondominant hemisphere (usually right)
attention to contralateral body and space
blood: MCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

primary visual cortex location and function and blood supply

A

calcarine fissure of occipital lobe.
Function: vision
Blood: PCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are optic radiations? location?

A

white matter pathways carrying visual info. damage can lead to field deficits.

location: travel from thalamus to visual cortex. pass under parietal and temporal cortex.
blood: PCA, MCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are lenticulostriate arteries? prone to what injury?

A

branches from MCA. supply basal ganglia and internal capsule.
in HTN, prone to narrowing leading to lacunar infarct. or rupture leading to intracerebral hemorrhage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what perfused by anterior choroidal artery? source of this artery?

A

from internal carotid artery. to globus pallidus, putamen, thalamus, posterior limb internal capsule (corticobulbar and corticospinal tract)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what perfused by thalamoperforator arteries? blood from where?

A

to thalamus and portion of posterior limb of internal capsule.
arise from proximal posterior cerebral arteries near top basilar artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what perfused by recurrent artery of Heubner? arises from?

A

head of caudate, anterior putamen, globus pallidus, internal capsule.
arises from anterior cerebral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Large MCA infarcts gaze preference toward….

A

side of lesion. especially acutely.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

small-vessel infarcts called? most common cause?

A

lacunar infarcts. chronic hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

source of embolus (5)

A
  1. cardioembolic infarcts: originates in heart, occurs in conditions such as atrial fibrillation (thrombi at fibrillating left atrial appendage), myocardial infarction (thrombi form on hypokinetic or akinetic regions of infarcted myocardium), valvular disease (thrombi form on valved leaflets or prosthetic parts)
  2. artery-to-artery emboli (from stenosed segment of internal carotid artery), vertebral stenosis,, ectatic dilated basilar artery
  3. dissection: of carotid or vertebral arteries resulting in thrombus formation that can embolize to brain
  4. atherosclerotic disease in aortic arch
  5. patent foramen ovale: allows thromboembolus in venous system to bypass lungs and pass to lleft side heart to brain.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pure motor hemiparesis (lacunar infarct). symptoms, location, blood supply

A

symptoms: unilateral face, arm, leg weakness with dysarthria.
location: posterior limb internal capsule (lenticulostriate arteries, anterior choroidal artery, perforating branches posterior cerebral artery), ventral pons (ventral penetrating branches basilar artery), corona radiata (MCA branches), cerebral peduncle (PCA branches)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ataxic hemiparesis (lacunar infarct) symptoms? location? blood supply?

A

symptoms: unilateral face, arm, leg weakness with dysarthria and ataxia on same side weakness
location: posterior limb internal capsule (lenticulostriate arteries, anterior choroidal artery, perforating branches posterior cerebral artery), ventral pons (ventral penetrating branches basilar artery), corona radiata (MCA branches), cerebral peduncle (PCA branches)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pure sensory (thalamic) lacunar infarct

A

location: ventral posterior lateral nucleus of thalamus (thalamoperforator branches of PCA)
symptoms: sensory loss of primary modalities in contralateral face/ body, sometimes thalamic pain syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

sensorimotor lacunar infarct. symptoms? location? blood supply?

A

symptoms: combination sensory and motor deficits contralateral side
location: posterior limb internal capsule and either thalamic VPL or thalamic somatosensory radiation (branches PCA or lenticulostriate arteries of MCA)

16
Q

basal ganglia lacunar infarct

A

symptoms: usually asymptomatic but may cause hemiballismus (involuntary wild flinging movement of one side arm/leg)
location: ccaudate, putamen, globus pallidus, or subthalamic nubleus (lenticulostriate of MCA, anterior choroidal of IC or Heubner’s arteries of ACA)

17
Q

common risk factors stroke?

A

HTN, DM, hypercholesterolemia, smoking, family history, cardiac disease (valvular disease, afib, patent foramen ovale, low EF), prior history of stroke or vascular disease

18
Q

headache most common for anterior or posterior circulation infarcts?

A

headache more common posterior circ. infarct. headache in 25-30% of ischemic strokes

19
Q

where do lacunar infarcts occur?

A

affect deep white matter and nuclei of cerebral hemispheres and brainstem.

20
Q

tissue plasminogen activator (tPA). who gets it?

A

no hemorrhage on CT and symptoms started within 4.5 hours.

21
Q

risks tPA?

A

increase risk intracranial and systemic hemorrhage.

22
Q

preventive measures after stroke.

A

modifiable risk factors: HTN, smoking, hypercholesterolemia), statins, aspirin

23
Q

bruit

A

whooshing sound in carotid upon auscultation. continues into diastole

24
Q

tests for carotid patency?

A

Doppler ultrasound, magnetic resonance angiography (MRA), CT angiography (CTA), conventional angiography is only occasionally needed as the “gold standard”

25
Q

treatment for 100% occluded vs. partially occluded carotid artery

A

100% occluded treat with anti-coagulant bc risk surgery and throwing clot too high.
partial occlusion: carotid endarterectomy: clean out plaque.
also exploring stents and angioplasty (for those with high surgical risk for traditional carotid endarterectomy)

26
Q

dissection of artery

A

small tear on intimal surface of artery, allows blood to burrow into vessel wall producing dissection. flap protrudes into vessel lumen and thrombus forms. can embolize distally.